A psychologist's experience of cancer and life

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Monthly Archives: February 2017

That is the question, isn’t it? Especially at this time of year when my registration fees are due. Do I sock more funds into that failing business of mine or call it a day? I wish there were an easy answer.

Although my health was fairly stable this past year, I have not actively sought clients for some time. My psychologist friends know I am working and send the occasional client my way, but my phone isn’t ringing off the hook. This past year, I didn’t even earn enough to warrant a call to my disability insurer to plead compassion for exceeding my earnings limit.

What does this mean? It means that it’s costing me money to keep my office door open. It means that, in order to make myself available on the off chance a client calls, I am investing in remaining accredited. It means that, despite my efforts to trim my expenses to the bare minimum, my expenses have exceeded my income this past year.

Believe it or not, pride is not the driving force for wanting to remain a psychologist. I, like any other schmo, could call myself a counsellor instead, even though I have a psychologist’s skills and training. As a counsellor, I could do exactly the same work with the same expertise; I just wouldn’t be able to call myself a psychologist. I’d also save the cost of psychology registration and malpractice insurance. But I don’t want to be a counsellor.

Falling under a regulating body means that I’m held to certain ethical standards, and my behaviour is monitored. There is comfort and familiarity in our ethical guidelines, which are in place to protect clients first and foremost, but also to protect me if I am falsely accused of behaving inappropriately as a psychologist.

Many of the rules will be familiar to you, and are common sense: don’t have sex with your clients; don’t see your best friend or your hair stylist in therapy (no dual relationships); don’t barter your fees for your client’s services, such as car repair; don’t blab to your neighbours about your clients. There’s an abbreviated ethics summary.

Sure, I could uphold these standards even as a counsellor, but I’d have no one watching over me if I blew it, which leaves my client at risk. How does a client report an ethical infraction if no governing body is holding that counsellor accountable?

Then there’s the money issue. If I’m a counsellor, clients will need to pay for my services themselves. (No extended health care plan would cover an unregulated counsellor.) That cost would be prohibitive for many clients. Even those who don’t have extended health care coverage can claim a psychologist’s fees on their taxes at year end. Without accreditation, my fees are no longer considered a medical expense.

For all these reasons, I’m going to throw away more money again this year, in case my office telephone rings. Why, just this morning, the dentist’s office called to schedule a cleaning.

I had to shut down my office unexpectedly for months when I was first diagnosed with leukemia. I had no choice then; I was too sick to work. But now I can choose to keep my office open, so I will. What have I got to lose, except perhaps more money?

I’ve had my new cellphone for a few months now, and still I’m struggling to master the sophisticated features. The phone allows me access to my email, my blog, and the internet. I could even post to my Facebook account if I had a Facebook account. I didn’t realize I’d be buying a mini computer. My retired phone pales in comparison.

Then there’s the joy of texting. Once I overcame my emoji resistance, I became excited to have access to such a wide variety of expressions, and I now pepper my texts liberally with random little yellow faces. Turns out emojis are no longer just faces, however; there are families and animals and objects and musical instruments and places and…oh, you know this already.

As I type my vacuous texts, the corresponding emojis pop up so I can insert them in place of the word(s). That’s how I discovered my favourite, the stinky poop emoji, that little brown pile–what other colour would it be?–above. (I only typed “stinky poop” in my text to find that emoji; I was not, and I repeat NOT, texting anyone about my poop.) You heard it here last folks: written words are becoming obsolete.

No one told me that learning all those facial-expression emojis would be like acquiring a new language altogether. Turns out I’m an ESL (that’s Emoji as a Second Language) flunky. I have seen repeated pairings between emojis and my written words–I type the feeling word and each time it prompts the corresponding emoji–but my near vision is so poor that, as far as I can tell, every little yellow face looks the same. Angry? Upset? Happy? I have no idea! I’m finally rid of all those uninterpretable little black squares I used to receive in my texts, only to find myself face to face with indecipherable faces. Maybe I don’t lack an ear for languages after all; rather, I don’t have the eye for them.

There’s a commonly held belief that children learn new languages more easily than adults. From my five-minute extensive research review, I’ve learned that children more easily master the pronunciation of a new language than adults, and they have the advantage of new-language immersion at school. But, according to my quick but thorough scan of the research, so long as they’re not too far over the hill, adults can also master new languages under the right conditions.

What if all these researchers are barking in the wrong ear? Hasn’t anyone considered the impact of kids’ superior vision on language learning? I, for one, believe there is a strong correlation between visual acuity and language acquisition. I don’t need a young person to teach me those they-all-look-the-same-to-me emojis; I will eventually master them on my own, thank you very much. Right after I buy a new pair of reading glasses.

In the meantime, if you notice that my emojis don’t quite correspond to the sentiment I’m trying to convey in my text, don’t mock me. I’m so far over the hill that you may need to cut me some slack.

I really like the accountant I’ve consulted for many years. Mr. Money is a friendly, helpful, and ethical professional who has consistently reduced my stress at tax time. He appreciates how organized I am when I submit the required information to his office. Come to think of it, he is the only person in the universe who thinks I’m organized. Perhaps I should question his judgement after all?

I last met with Mr. Money soon after my leukemia diagnosis in 2012. I was scrawny and weak, having just left the hospital a few months prior. I needed his help sorting out the tax implications of slowing down my business. I sought his assistance over the following few years, but then realized that paying someone to complete the taxes on my paltry income was not financially viable anymore, so I did them myself.

J. and I are returning to Mr. Money this year. J. needs assistance with her complicated tax situation, while I’ve decided life is too short to do paperwork. To this end, I emailed last week to set an appointment. How did he respond? “So glad to hear from you!” It made me feel all warm and fuzzy inside. We’ve always gotten along well, but I wasn’t sure he’d even remember me. Perhaps I’m hard to forget?

Let’s examine his opening further, though. Do you read the subtext like I do? All I hear is, “You’re still alive!” Maybe I’m overinterpreting, but this is the way my mind works. We haven’t spoken in some time; of course Mr. Money would think I’ve kicked the bucket. I have leukemia after all, and I looked like death last time I saw him. I’d probably be thinking the same if I were him.

Then I considered all the other inappropriate ways he could have opened his letter. “I thought you’d be long dead by now.” “I figured you were six feet under.” “I’ve been watching for your obituary in the paper.” “I wondered why I hadn’t yet heard from J. about your estate taxes.” There are so many other off-colour options, I can’t possibly fit them into one blog post. With your creative minds, I’m sure you’ll come up with others yourselves.

Therein lies the awkwardness of the chronic cancer survivor’s initial interaction with anyone following a long lapse in contact. How does the non-cancerous person withhold surprise? What if that person shared his inside voice? How would that go over?

When Mr. Money opened his letter as he did, I could sense his relief, which reminded me that he and I both believed I’d be long through the pearly gates by now. His response also reminded me that, by some twist of fate, I’m still here. Yes, I’m alive, and can’t wait to dump this year’s taxes on him. His expertise is worth every penny.

I’m aware, however, that Mr. Money may not be so happy to see me when he learns that, four years in, my business continues to operate at a loss. I’m still subsidizing the few clients I see because I’m not ready to stop calling myself a psychologist. “Hey Mr. Money, while you thought I was dead, in fact I’ve been throwing my hard-earned savings into a failing business.” Hopefully he won’t feel a need to lecture me. I hate lectures.

Months ago now, two PALS volunteers, one of whom happened to be a social worker, interviewed me to see if I too would make a suitable PALSie. Ms. Therapist went off script near the end and asked me how I’d contain my therapist self in this role of PALS volunteer. What a great question. I was stumped.

As a helper by profession, I find it hard to ignore that supportive instinct in other settings. The job of a PALS volunteer is not to be a therapist to the people we visit, many of whom I’ll meet only once. I must deliberately set internal boundaries to stop myself from becoming overly or inappropriately involved with these visitees.

Setting these boundaries is not easy, I’ll admit. During the interview, I acknowledged I’m not great at shutting off this supportive side of myself. I told the interviewers that I often avoid the potential altogether by not informing acquaintances that I’m a psychologist. Sometimes Knowledge of my profession alone may encourage people to seek my support inappropriately. I may have previously mentioned a fellow gym goer once seeking relationship advice while I was naked in the change room. Lesson learned? Once burned, twice clothed.

Because the role of the PALS volunteer is therapeutic by nature, I must be aware of maintaining my emotional boundaries at all times. This becomes harder as I get to know some of the residents in our assigned retirement home. In fact, I wavered last week during our regularly scheduled visit.

Have I mentioned that one wing of the residence Jelly and I visit is a hospice? Yes, people go there to die. As I was entering the building, I happened upon a woman I had met previously. She was leaving after visiting her mom, a hospice resident. This woman was obviously feeling emotional, but she stopped to greet Jelly and told me how much her mom had enjoyed the last PALS visit. She asked me to check in on her mom again that day.

According to the bounds of my role, I should have wished the daughter well at this point, but instead I said, “This [watching your mom die] must be hard.” I learned she’d been visiting daily and commended her for being such a good support to her ailing mom.

The daughter became teary, but I felt I had to acknowledge what she was going through. It felt better to risk making her cry than to ignore her impending loss. Boundary crossed. I didn’t hand her my business card (although I had one in my wallet) or mention that I’m a psychologist; I wished her well and off she went.

Sadly, I don’t know if I’ll see that woman or her mom again. The thing about a hospice is that people aren’t often there long. I did take Jelly to visit the mom, who looked all the more frail since we were last there. She was exhausted and politely declined our company. I respected her boundary and moved on.

All Jelly and I can do is show up and hope to provide comfort. Sometimes we are successful. If that involves crossing the occasional boundary, so be it.

Do you young’uns remember the Newlywed Game? It aired during my formative years, took a few decades off, and reappeared in 2009 for a few seasons. In it, a newly married husband and wife had to answer questions their spouse couldn’t hear. The couple was awarded points if the wife’s questions matched the husband’s, or the husband’s matched the wife’s. You get the idea. In the later version, even a few gay couples were on the show. That’s social progress for you.

This is my sixteenth Valentine’s Day with J. Sixteen whole years, and I know everything about her. I think we’d be masters at the Newlywed Game, even though we’re far from newlyweds. We’re not able to finish all of each other’s sentences (just most of them) but I can often predict what she’s thinking. I know her likes and dislikes, I know how we’re similar and different. Lately I’m batting close to 1000.

For example, when we were out walking yesterday, I pointed out a car colour I liked, and J. agreed but added, “I’d probably get sick of it.” I could have told you that even before she uttered the words. Call me psychic.

I can also predict with certainty that if J. likes a pair of shoes, I will not. “Why don’t you try these on, honey?” she says to me. “It’s alright, sweetie,” I respond, “they’re ugly/institutional/grandmotherly. They’re all yours, i.e., your feet can look ugly/institutional/grandmotherly.” As a skilled therapist, I can assure you that it’s healthy for couples to agree to disagree sometimes, especially on matters of such critical significance.

To prove how well we know one another (since the Newlywed Show is no longer an option), last night we both took a compelling questionnaire currently making its way around the internet, “Which country fits your personality?” J.’s responses classified her as UK (that’s obvious–she loves beer), while I classified myself as Japan. Japan? I didn’t even pick sushi as my favourite meal (immunocompromised diet and all)! J. laughed until she cried envisioning me as Japan.

J. thinks she knows me so well that she responded a second time for me to see if the outcome would be different. She must figure she’s a better judge of my character than I am, which is often true. What country did her responses make me? Japan, yet again. And she didn’t even pick sushi as my favourite meal either!

So of course the challenge was on: I re-rated her to see if, with my responses, she remained UKish. But no, according to me, she too was Japan! I have no idea why everything I touch turns to Japan. I even chose beer over tea for her, although she drinks a lot more tea than beer. Sure, I selected sushi for her but only because she loves sushi.

So I must concede that, although I may indeed know which car colours J. would quickly tire of, I clearly still have many things to learn about my beloved, as she obviously does about me. May we have many more years to improve our batting averages.

Happy Valentine’s Day. May you receive as much chocolate as I hope to. (Another relationship tip: there’s nothing wrong with the odd hint.)

If you recall, I wrote about the unanticipated responsibilities of the cancer patient a few weeks back. To summarize for those of you who may not have committed my posts to memory, I learned the hard way that I had to arrive reliably when expected or people would think I had died, or perhaps they’d worry about where I was, but you get my drift.

With this in mind, I am writing to assure you that I am not dead. I missed yoga Thursday, which is highly atypical, and I haven’t been spotted at my usual haunts (the grocery store, the library, the dog park) over the past few days, but I am indeed alive, just far from home.

On Wednesday, J and I had no trouble at all crossing the U.S. border, even as a gay married couple. I guess we don’t look like terrorists to President Idiot. (On that note, did you hear a two-year-old potential terrorist in need of brain surgery was allowed entry into the U.S. even before the courts lifted the travel ban? Turns out not all preschool Muslims are terrorists after all.)

Of course I feel guilty being here when others are fearing they will not be allowed into the country, but our trip was planned before (some call him POTUS, I call him) President Putz started undoing everything his predecessor had worked so hard to accomplish. We would have lost a lot of money had we cancelled. No travel insurance for the cancerous, remember?

So here we are, far south of the 49th parallel, escaping a brutally cold spell back home and taking a break from real life. J. is learning to forego marrying people for a week, which is a challenge given how much harder she’s been working since retiring. (I realize that last sentence is oxymoronic, yet consider who we’re talking about here.) Retirement, my tuchus, I say. Meanwhile, I am learning how to take a break from volunteering since I too have been biting off a bit more than I can chew (and I don’t mean food here) of late.

How perfect is this trip? Friendly customs agent, flight arrived on time, and the rented red VW Beetle practically drove itself to our well-situated and well-appointed apartment. I am thoroughly enjoying the gas stove I’ve always wanted, and, to J.’s amazement, I haven’t yet burned the place down! Sure I forgot toothpaste, but that problem was quickly remedied. Turns out Americans brush their teeth too.

We can walk to everything we need. We’ll easily score a gift for Jelly while we’re here in one of the fancy pet stores. Who am I kidding? We never bring home gifts for Jelly. She doesn’t realize we should since she’s a dog. If I do see a squeaky President Putz dog toy, though, I may not be able to help myself.

When I get back home, I’ll have real life to contend with, but for now, I’m enjoying my short-lived fantasy of no responsibilities, no obligations, and no cancer.

So if you were worried about my absence, worry no more. I’m busy living every vacation day like it is my last. Time to head out in search of that dog toy.

I’ve been finding my three-hour Blood Services shifts exhausting, since they’re closer to four hours by the time I drive to and from the site. I love the work, but I’m comatose by the end of my shift and it takes me a full day to recover. Last week, I asked the volunteer coordinator if I might shorten my shift to a manageable two hours. Thank goodness she was responsive and accommodating, as is her way.

For my first two-hour shift yesterday, the driving was atrocious (heavy snowfall + deep freeze = icy road conditions), so I asked J. to chauffeur me. Some days I’m just not up to driving, and the thought of taking transit in such inclement weather was grossly unappealing. J. dropped me off early and retrieved me a few hours later. On a good note, with my shorter shift, I didn’t resort to keeping myself awake by eating the high-sodium vegetable soup.

I climbed into J.’s warm car (the person who invented heated seats should win a Nobel Prize for Coziness), only to have her say, “Is that a booger on the end of your nose?” My first reaction, after my abject horror of course, was to say, “That’s highly possible.” Then I cried, “Why didn’t you notice this problem on the way to the clinic rather than on the drive home?”

I admit I’m not one to look in the mirror before I leave the house. That’s why so often my fly is undone, I have lunch on my shirt, I have food between my teeth and, it turns out, I sometimes have boogers on the end of my nose. Even if I did inspect myself in the mirror, my near vision is so poor that I’d need reading glasses to notice anything untoward.

Now let’s remember here that I’d just spend the previous two hours serving food to the generous donors, who’d trekked to the clinic through cold and deep snow. Thankfully our eye (or nose) contact was fleeting. I didn’t stand over people’s tables watching them consume their treats; I delivered the wares and went back behind the counter with all the other volunteers. (Alas! Did the volunteers notice too?) Now I’m wondering how many of the donors were thinking, “I don’t want the booger woman serving me my food.”

There is an obvious solution to this problem: I could start looking in the mirror before I leave the house. Who am I kidding? I haven’t been concerned with my appearance for over 53 years; do you think I’m suddenly going to start checking myself before I go out? I don’t want to see how large the black circles are under my eyes, or how bloodshot my eyes are from chronic fatigue, or even how much I look like I have leukemia.

I have a better solution, assuming you’re willing to help. From now on, please invoke the Booger Rule, i.e., alert me if I have boogers on my nose(or greenies between my teeth, or lunch on my shirt, or an open fly). Maybe you wouldn’t want to know, but, trust me, I would. My fleeting embarrassment is surely preferable to my sporting visible boogers all day, don’t you think?

Can you believe I started my blog three years today? As a writer, I decide which stories to highlight and how I’m going to tell them.These decisions are often completely arbitrary. Speaking of which, I ended Friday’s tale prematurely because I felt I’d dragged you down enough for one day. That and Joy doesn’t like it when Sadness steals the limelight.

Now that you’ve had the weekend to recover, I’ll finish what I started. After my chance encounter with Mr. Shuffle at the Cancer Centre, I headed back to the car. J. could tell immediately that my mood had shifted. I was glum and quiet, so she asked, “Whassup?”

I described my encounter, and how bad I felt for this man, who was unwell and appeared to be alone. (His family could have been waiting for him, for all I know; I just didn’t see anyone with him.) I’d made many potentially erroneous assumptions about his life. Then I added, “My cancer journey is so much easier than everyone else’s, I’m so lucky to have a good leukemia–a good leukemia? I said that?–and an easy chemo, blah blah blah.” You get the idea.

Enter the Validator, J.’s other superhero persona. (You’ve already been introduced to the Anti-Procrastinator, who completes tasks before anyone realizes they need to be done.) She said, and I paraphrase here, “Remember when you almost died? Remember when you were so weak that you couldn’t tie your shoes without tipping over? People stared at you because you looked so sick. Remember how many months it took for you to regain your strength and to complete a 5-star Sudoku again [excuse the humble brag]? You’re not working in the profession you love and you’re tired all the time and your cancer has been no piece of cake.”

You may recognize this old theme in my blog: the incessant need to convince myself that my cancer is lame, and that my suffering is small potatoes compared to everyone else’s. Heck, I’m 4-1/2 years in, and I’m not even dead yet. I’m a cancer failure.

All these things are true. I’m still alive, but cancer still courses through my veins. At one point, my leukemia made me as weak or maybe even weaker than Mr. Shuffle, not that cancer is a competition. You know this already; I’m just trying to convince myself that I don’t have to minimize my experience. I’m reminding myself yet again of the dangers of social comparison, which sometimes makes me feel better about my situation, but more often makes me feel worse.

So Mr. Shuffle, I’d love to nurse you through your illness, but I’m hoping you have your own community of support since I don’t have the energy. Believe it or not, I’ve got cancer too. I may look perky now, but my road has had its share of bumps. I hope you’re able to regain your strength and that you’re feeling better soon. Fight the good fight and know my heart is with you.

Then the Validator wisely reminded me that feeling crummy is often one stop on a cancer patient’s way to healing. Wise woman, that Validator. I hope she’s right, for Mr. Shuffle’s sake.

I usually try to end my blogging week with an upbeat post. Something funny or light to make you laugh. Who wants to hear from Debbie Downer right before the weekend? But Sadness nixed my planned frivolity this week, and I always listen to Saddy. Everyone should listen to Saddy.

Yesterday J. drove me up to the Cancer Centre to pick up my chemotherapy refill. (I’ve given up on having my drugs mailed to my home since that unfortunate Canada Post fiasco last year.) J. waited in the car while I popped in to the pharmacy.

Things went as planned. I made my way through the hoards of patients–cancer stops for no one–hopped onto the elevator, and headed to the pharmacy. I showed the kind pharmacist my red card (also known as the PROOF YOU HAVE CANCER card), and she gave me my little brown paper bag, as if I were hiding condoms or something (not that I’d know about that).

I returned to the elevators, which at that moment were overflowing with patients going up. I needed to go down. After the uppers were gone, I pushed the down button while I watched an older gentleman shuffling toward me very slowly. I asked him where he was headed, and he said he too was going down. “Great. I’ll have company,” I said, perhaps a bit too jovially given the environs.

When our elevator arrived, I let Mr. Shuffle enter first. I followed him in and pushed the button for us. He leaned against the elevator wall as if it were holding him up. After the doors shut, he said, so quietly I almost didn’t hear, “I am so weak.” I looked at him sympathetically but did not know how to respond, so he added, “The chemotherapy.” I touched him on the arm and said, “Cancer is hard.”

I struggled to know how to respond, and I still wonder if I said the right thing. Is there ever a right thing to say? It wasn’t the time or the place to get into the nitty gritty of his treatment; we had only one floor to travel. I didn’t want to minimize his experience with a “Things will look up!” because I didn’t know if this would be true for him. I could have given him a hug, but strangers don’t often hug, and I might have tipped him over. It’s more than that. Since he seemed to be alone, I wanted to bring him home and take care of him, but my boundaries stepped in.

Cancer is hard in different ways for different people. I’m hoping this man sensed that I could see that he was struggling. Maybe I provided comfort, however fleeting. And I’ll hope there comes a time when he doesn’t feel so weak. But right now, I feel sad that anyone has to endure the worst of cancer. I know it’s not easy.

I still feel sad when I think about this man, but I have to let that go today. Joy is joining Jelly and me at the university, where we’ll be cheering up some stressed-out students. Volunteering, my purely selfish endeavour.

Last week I started a novel that was one of the Globe and Mail’s books of the year. I have the utmost respect for the Globe book reviewers. If they tell me it was a book worth reading, and it sounds compelling, I read it. Often I agree with those reviewers.

This highly recommended book wasn’t a bad book, it was readable, but I was plodding through it. Then it hit me that I wasn’t enjoying it. The main character was a despicable guy from the outset, and he didn’t get any better. I didn’t want to know more about him; I just wanted him to go away. So I stopped reading. Not only that, I didn’t even skim the remainder of book to find out what happened because I didn’t care. Yes, I quit the book outright.

While I was plodding through this book, my overzealous conscience was haunting me, “You started the book. You’re half way through. You must finish it.” That same conscience prompted me to attend every single one of my lectures in university (does anyone do that?); it ensured I was over prepared for any exam I wrote (with mixed results); and it prompted me to obsess for days over any essay or report.

I can recall attending psychology conferences that bored me silly yet staying right to the end. Why, Annie, why? I’ve never left a yoga class I really didn’t like since I wouldn’t want to hurt the teacher’s feelings. My internalized Big Brother is watching me all the time.

Ditching last week’s novel may seem like small potatoes, but it was huge for me. It’s taken me years to learn I can let go of things I don’t enjoy. Why persist in activities that don’t bring me any pleasure or satisfaction? What’s the point? Wouldn’t my time be better spent engaged in something more rewarding?

I realize we can’t do only the fun stuff all the time. Even beach bums need money to buy food. If we want to graduate, we all have to endure the dreaded required courses we’d never choose to take. Sadly, there’s drudge work even in jobs we love. We need to fulfill those obligations because that’s life. Rather, I’m referring to those activities we take on by choice.

Now that I’ve tried quitting, I’d highly recommend it. Just like some workplaces are toxic and some marriages are abusive, some books are not to my taste. Why not redirect my energy to something I’d enjoy more? Consider Oliver Sacks’s wisdom as he neared death, “There is no time for anything inessential.” Even you cancer-free folks might want to consider this notion.

So bail on that continuing education course you thought you might enjoy but is actually boring you to death. Take a nice walk or enjoy lunch with a friend instead. Trust me, the teacher won’t miss your incessant yawning from the back row.

The following day I started another book, and it was so engaging, I couldn’t put it down. Maybe it wasn’t deemed worthy of the Globe’s annual list, but I’d highly recommend it, if that counts for anything.